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Individual

DR. DOUGLAS J BENTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
6092 FENTON RD, FLINT, MI 48507-4761
(810) 239-4697
(810) 239-4553
Mailing address
G-6092 FENTON RD, FLINT, MI 48507
(810) 239-4697
(810) 239-4553

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101008533
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3235403
MI
Enumeration date
09/02/2006
Last updated
11/10/2008
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